Jed - a number of things could account for high fasting blood sugars. Fasting needs to be defined, but since you say 'most days', I assume you are checking the morning after a 'normal' evening meal. Diabetics, depending on how long and how severe the disease, often have digestive issues, with food moving more slowly through your digestive tract, prolonging its absorption, and keeping blood sugars high longer.

If slower absorption is not the culprit, consider that your liver is constantly making glucose from glycogen after food is absorbed, and your metabolism is slower during sleep, so your blood sugar can rise.

If you are active during the day, your blood sugar will tend to normalize, and since HbA1c is an indicator of AVERAGE blood sugar over a three-month period or so, your result (which is HIGH normal, BTW) may fall into the range you mention.

While a good general indicator of your level of control, HbA1c doesn't account for the magnitude of the high excursions, and is not an indicator of the damage such excursions cause. As an example, pancreatic islet cells find sugars in the 200 range toxic, and can die, resulting in less ability for the pancreas to secrete insulin, compounding the problem. There is evidence that those cells 'wear out' trying to produce the levels necessary to overcome your insulin resistance at that level.

I don't want to sound preachy, but what is considered 'acceptable' for HbA1c really isn't. An arbitrary number ("I'm below 7.0 (6., so I'm OK") is false security. Doctors use it to gauge their success in treating you, but they don't have to live with neuropathy, and other degenerative illnesses that accrue from being just under their arbitrary acceptable level.

Here's a REALLY good website that covers all this: http://www.phlaunt.com/diabetes/

The woman who authors the sites is a bit of a maniac on the subject, but well-researched, and well-meaning, if a bit extreme.

Talking about this is one of the best ways to treat it. Hope this thread continues.

I started this thread last January because I was having problems with symptoms associated with hypoglycemia (low blood sugar). To quickly summarize what transpired in the following months, keeping in mind that I don't smoke, drink alcohol or sodas, I eat healthy meals (thanks to my wonderful wife) and exercise daily but I'm a little overweight: A battery of blood tests revealed no abnormalities. I subsequently cut out all caffeinated drinks and finally came to the conclusion that I was experiencing reactive hypoglycemia as a result of drinking a breakfast drink containing wheat and some other unusual ingredients. However, throughout the year I have continued to be plagued by these same symptoms...(A person with hypoglycemia may feel weak, drowsy, confused, hungry, and dizzy. Paleness, headache, irritability, trembling, sweating, rapid heart beat, and a cold, clammy feeling are also signs of low blood sugar. In severe cases, a person can lose consciousness and even lapse into a coma.)

Truthfully, I have never really completely cut off the coffee, but I have continually experimented with 1,2 or 3 cups a day while I have searched the internet for answers. I have recently discovered that some people develop a hypersensitivity to caffeine and the onset of this caffeine allergy can come at any time, even to someone who has been accustomed to drinking 8-10 cups a day for years. Caffeine allergy causes reactions in brain tissue, particularly the prefrontal cortex, producing a lack of focus and comprehension, lack of organizational skills, and a loss of verbal and social inhibition. Caffeine also raises catecholamine levels, which causes the body to produce more dopamine and increases activity.

Now, here's the answer I have been looking for: The symptoms associated with hypoglycemia are sometimes mistaken for symptoms caused by conditions not related to blood sugar. For example, unusual stress and anxiety can cause excess production of catecholamines, resulting in symptoms similar to those caused by hypoglycemia but having no relation to blood sugar levels. Therefore, I can now deduct that the caffeine is raising my catecholamine levels which in turn produces these symptoms which mimic hypoglycemia.

So, now that I know for certain what is going on, I know how to deal with it. I have tried to cut out all caffeine completely for months at a time, but I never got over that tired and sluggish feeling with no "get up and go" and I stayed somewhat depressed most of the time. So I have been experimenting now with 1/2 bag of 3 in 1 with the 10% coffee content in a small cup of hot water each morning after breakfast, but never on an empty stomach. So far this dosage is working well. I get the "pick me up" that I need each day, and I don't get the symptoms of hypoglycemia.

I wanted to report these findings on the forum because I am sure that there are probably others out there who are having similar complications, so all coffee drinkers should be aware and consider your caffeine intake and how it affects your health. I also discovered that there is no such thing as decaf coffee or tea. You're still getting 15% of the caffeine in a regular cup of coffee or tea, and for those of us who are hypersensitive, that can be a lot.

After my small morning cup I have to make sure that I don't drink a tea or soda with caffeine during that 24 hour period or I go into caffeine overload and it wrecks havoc on my body. Sorry to make this so long, but I hope it helps someone!

Thanks Steve -- Again, an excellent post with great info and a very informative, edifying reference, which I've been perusing.

I've been looking into this area for a few years and it all jives with what I've learned and personally experienced.

Excellent point about not being lulled into false complacency simply because of "decent numbers."

One point where I'd love to be proven wrong is the possibility of reversing diabetes, but due to islet damage in the pancreas, I gather from most sources that's not possible -- only managing it and controlling it are.

And Mr. Parrot, my wife just gave me some (what is it, man snow lotus) man bua hee mah -- quite tasty: kind of a cross between champoo & salee & maybe potato (is there an "e" on the end?). Thanks for the tip. If anyone has any links to research on this, I'd like to see them. I'll have a look around as well.

And yes, good thread. There must be others who can contribute and add to this.

Jed - the hallmark of type-II diabetes is insulin resistance, NOT lack of insulin, at least until you've had it long enough to destroy islet cells. Then, it becomes a combination of the two. Older medicines used to stimulate insulin secretion to compensate for the insulin resistance (Glyburide, etc.). Newer medicines, like metformin, reduce insulin resistance, and so avoid the undesirable side effects of excess insulin in the blood, namely, fat storage, which is PRECISELY what causes insulin resistance in the first place.

It's not the NUMBER of fat cells, but their volume/surface area ratio that determine insulin resistance. When you lose weight, you don't lose fat cells, they just become smaller. The surface area increases as the square of the radius (4*pi*r^2), while the volume increases as the cube of the radius (4/3*pi*r^3), so the volume gets bigger much faster than the surface area, and insulin resistance goes up.

Interestingly, a now-discredited, dangerous medicine, Avandia, and it's cousin Actos, worked by stimulating the growth of new, but relatively tiny fat cells, which, because of their size, used insulin efficiently, and helped reduce glucose. This is terrible, because these new fat cells can grow just like the old ones, and eventually contribute to the problem, same as the old big ones! Many heart attacks occurred before the FDA in the US finally issued a warning for these meds.

So, what to do? Lose weight, shrink fat cells. Get liposuction to reduce the NUMBER of big fat cells (found in your abdomen), except that the risk probably outweighs the benefit.

I guess the best we can hope for the combo of losing weight (shrinking fat cell volume), and modifying our behavior to minimize blood sugar excursions, and to promote better heart health. That's the closest to a cure I can think of.

Everyone should bear in mind that we are talking about advanced, long-standing cases of type-II diabetes. People newly diagnosed can be med and symptom-free with just a few pounds of weight loss. No need to let it get out of hand...

Measuring your blood sugar, noting the effects of what you eat, and how you exercise, are the tools you need to beat it. Genetics is genetics, but you can influence the outcome greatly in your favor.

I earlier said มันบัวหิมะ mahn bua hee mah is jicama. I think the name is yakon root (http://www.anniesremedy.com/herb_detail514.php) whereas jicama is probably what's known as mahn gaeow (มันก้ว). Sorry about that. By the way, mahn gaeow is known as a diabetic-friendly vegetable.

I went to the wholesale market just east of MACRO on the same side to find มันบัวหิมะ. They only sell 10kg bags for 230B, only one vendor agreed to sell us 3kg for 100B; juicy and not bland tasting like the มันก้ว. I do not know Thai, just Googled to see the photos before going to the market. The first one is brownish and longish; the second one is whitish and roundish. The second one is about a third in price of the first one, but I would still buy the first one.
Thanks, John.

On a recent check up and blood test, the Dr commented that a couple of items were a bit low (lower than average), and one a bit high, but didn't require any drugs. I can't interpret what they all were now. These were the first 3 items listed on the printout under CBC:

Hb: 13 (Normal range, Male: 14.2-16.3) and
Hct: 37.7% (Normal range, Male: 42.9 - 49.1)

And this one (maybe a bit towards the higher end of the range):

Differential WBC:
PMN: 63% (Normal range 40-70)

Blood Sugar was a bit high:

FBS: 113 (Normal range 70-110) (That I realise is Fasting Blood Sugar level)

The others were all normal or within the normal ranges.

Can anyone give me an interpretation of what the above mean/are and put the numbers into some perspective?

Thanks

my wife and i will be spending 3 months in udon starting in jan 2013 for a recon as to possible retirement there...i am type 2 diabetic i take 2 types of insulin humalog (fast acting 3x a day (25units)and lantus (slow acting over nite 40units 1x) also metformin 2x a day does anyone there take these and where are they available at what cost...thanks in advance for any help you provide look forward to seeing you all next year sincerely john and lek

Metformin is readily available and can be very inexpensive here if the generic is ok with you..

I am pretty sure that humalog and lantis are available, but they may not be available in the container you want. I am pretty sure they are available in pens, but maybe not so easy to obtain in bottles. What form do you require (I can ask at some pharmacies)?

thanks for ur reply pens are fine thats what i use now they normally come in boxes of 5 pens lantus normally last 5 weeks humalog about 3 weeks according to my diet excise and test thanks for ur help again john

Just to be clear, what concentrations are you using for Humalog and Lantus?

rick they both say 100u per ml thanks again for your help john

I found Humalog and Lantus at one pharmacy (did not check the concentration since I had not heard from you by then). Lantus-100U is available at many hospitals as well.

Wonder if the new Bangkok Hospital will have a good, proper diabetes specialist?

For that matter, anyone been there yet who can report on general quality of BKK Hospital Udon?

Doctors, service, prices, changes, etc.? (Perhaps a new thread is in order for this.)

Hi Arjay,
I hope you have already gotten answer to your question concerning your lab work. PMN ( Polymorphonuclear Leukocytes) or Neutrophils is a type of white blood cell. This group of WBC works to defense your body against bacterial infection and as a coping mechanism during severe stress. Hgb (Hemoglobin) and Hct( Hematocrit) are component of the red blood cells. Your values indicate that you're a bit anemic. However, this could be due to other factor as well, for example, your hydration status and time of day the blood sample is drawn. If you have other symptoms such as fatigue, poor appetite,memory problems, you might want to consider taking iron supplement. You should always consult with your doctor first. You can also obtain the the iron supplement over the counter.